Subclavian vessels injury: An underestimated complication of clavicular fractures

Table 1 Mechanism of subclavian vessel injury

Direct trauma	Indirect trauma
Laceration or puncture from sharp fracture fragments	Crush between clavicle and adjacent bones
Penetration from comminuted fragments after high energy mechanism	Acute external compression after hematoma formation
Perforation from fixation implants	Stretch after distraction injury
	Chronic compression from hypertrophic callus

Table 2 Types of subclavian vessel lesions

Subclavian artery	Subclavian vein
Laceration and tear	Laceration and tear
Occlusion, stenosis, and external compression	Thrombosis
Aneurysm, pseudoaneurysm, pseudoaneurysm rupture or thrombosis	Aneurysm
Arteriovenous fistula